Author of

• 11398

  +

  O11 - Symptom Management (ID 137)

  • Event: WCLC 2013
  • Type: Oral Abstract Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:B. Ivimey, I.N. Olver
  • Coordinates: 10/28/2013, 16:15 - 17:45, Bayside Gallery A, Level 1

  • 11407

    +

    O11.09 - Ibandronic Acid vs. Zoledronic Acid In Lung Cancer Patients With Skeletal Metastases. How Do They Compare? (ID 90)

    17:20 - 17:30  |  Author(s): I.A. Dimitroulis
    • Abstract
    • Slides

    Background
    Amino-biphosphonates are third-generation bisphosphonates which act by inhibition of osteoclasts. We have presented at two previous ATS conferences (Dimitroulis I.A. et al 2009, 2011), the role of each amino-biphosphonate separately. We set out to investigate the superiority or inferiority of Ibandronic acid (Ibandronate) over Zoledronic acid (Zoledronate), in terms of efficacy in reducing bone pain, and complications in patients with skeletal metastases due to Lung Cancer.

    Methods
    Ninety six patients with Skeletal Metastases due to Lung Cancer were enrolled, and were randomized on a 1:1 basis to receive infusions of Ibandronate (50 pts) or Zoledronate (46 pts) intravenously, every 21 days. Infusion time for Zoledronate (4mg) was 15 minutes, and for Ibandronate (6mg) one hour. Patients (pts) were analysed for pain relief, skeletal-related events (SREs) and adverse events. All pts underwent dental and cardiac examination before enrollment, and completed blood tests every 21 days. Bone scan was performed every 6 months. Blood tests (including close monitoring of calcium levels and renal function) were performed before each amino-biphosphonate administration.

    Results
    Patients in both arms were well matched for their diagnosis, stage of disease, burden of skeletal disease, and performance status. Median follow-up was 24 months. At 24 months, mean increases in British Pain Inventory pain scores were lower with Zoledronate compared to Ibandronate (0.43 vs 0.89 [p=0.03]). Analgesic effect as defined by the 4 point analgesic scale was less with Zoledronate as compared to Ibandronate. Incidence of SREs was not significantly different between two arms (35% for Zoledronate vs 38% for Ibandronate [p=0.2]). Median time to the first SRE was not reached in either arm. At 18 months of median follow up, percentages of patients with skeletal-related events were 41% in the Zoledronate arm vs 45% in the Ibandronate arm (p=0.05). Zoledronate caused fever in six (12%) patients and hypocalcemia in one patient. Ibandronate caused hypocalcemia in one patient (2.2%). No cases of jaw osteonecrosis, atrial fibrillation or renal failure (all of them possible side-effects of amino-biphosphonates) were observed.

    Conclusion
    Zoledronate is the preferred amino-bisphosphonate for its shorter infusion time, availability and relative benefits. It is slightly better than Ibandronate in reducing bone pain and preventing skeletal-related events. The only possible drawback is that, locally, Zoledronate is 1.3 times more expensive than Ibandronate (according to the mean European Economic Community price).

    Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.